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EP3076369B1 - Procede et dispositif destines a la representation d'un objet - Google Patents

Procede et dispositif destines a la representation d'un objet Download PDF

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Publication number
EP3076369B1
EP3076369B1 EP16161420.1A EP16161420A EP3076369B1 EP 3076369 B1 EP3076369 B1 EP 3076369B1 EP 16161420 A EP16161420 A EP 16161420A EP 3076369 B1 EP3076369 B1 EP 3076369B1
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EP
European Patent Office
Prior art keywords
image
subarea
coordinates
determining
spatial
Prior art date
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EP16161420.1A
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German (de)
English (en)
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EP3076369A1 (fr
Inventor
Bartosz Kosmecki
Andreas Reutter
Christopher ÖZBEK
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Scopis GmbH
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Scopis GmbH
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Priority to EP17203950.5A priority Critical patent/EP3330922B1/fr
Publication of EP3076369A1 publication Critical patent/EP3076369A1/fr
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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
    • A61B1/04—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor combined with photographic or television appliances
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
    • A61B1/00002—Operational features of endoscopes
    • A61B1/00004—Operational features of endoscopes characterised by electronic signal processing
    • A61B1/00009—Operational features of endoscopes characterised by electronic signal processing of image signals during a use of endoscope
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/06—Devices, other than using radiation, for detecting or locating foreign bodies ; determining position of probes within or on the body of the patient
    • A61B5/065—Determining position of the probe employing exclusively positioning means located on or in the probe, e.g. using position sensors arranged on the probe
    • A—HUMAN NECESSITIES
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    • A61B8/00—Diagnosis using ultrasonic, sonic or infrasonic waves
    • A61B8/42—Details of probe positioning or probe attachment to the patient
    • A61B8/4245—Details of probe positioning or probe attachment to the patient involving determining the position of the probe, e.g. with respect to an external reference frame or to the patient
    • A61B8/4254—Details of probe positioning or probe attachment to the patient involving determining the position of the probe, e.g. with respect to an external reference frame or to the patient using sensors mounted on the probe
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    • A61B8/5215—Devices using data or image processing specially adapted for diagnosis using ultrasonic, sonic or infrasonic waves involving processing of medical diagnostic data
    • A61B8/5238—Devices using data or image processing specially adapted for diagnosis using ultrasonic, sonic or infrasonic waves involving processing of medical diagnostic data for combining image data of patient, e.g. merging several images from different acquisition modes into one image
    • A61B8/5261—Devices using data or image processing specially adapted for diagnosis using ultrasonic, sonic or infrasonic waves involving processing of medical diagnostic data for combining image data of patient, e.g. merging several images from different acquisition modes into one image combining images from different diagnostic modalities, e.g. ultrasound and X-ray
    • G—PHYSICS
    • G06—COMPUTING; CALCULATING OR COUNTING
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    • A61B90/36—Image-producing devices or illumination devices not otherwise provided for
    • A61B2090/364—Correlation of different images or relation of image positions in respect to the body
    • A61B2090/365—Correlation of different images or relation of image positions in respect to the body augmented reality, i.e. correlating a live optical image with another image
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    • A61B90/36—Image-producing devices or illumination devices not otherwise provided for
    • A61B90/37—Surgical systems with images on a monitor during operation
    • A61B2090/378—Surgical systems with images on a monitor during operation using ultrasound
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    • A61B6/5229—Devices using data or image processing specially adapted for radiation diagnosis involving processing of medical diagnostic data combining image data of a patient, e.g. combining a functional image with an anatomical image
    • A61B6/5247—Devices using data or image processing specially adapted for radiation diagnosis involving processing of medical diagnostic data combining image data of a patient, e.g. combining a functional image with an anatomical image combining images from an ionising-radiation diagnostic technique and a non-ionising radiation diagnostic technique, e.g. X-ray and ultrasound
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    • A61B8/46—Ultrasonic, sonic or infrasonic diagnostic devices with special arrangements for interfacing with the operator or the patient
    • A61B8/461—Displaying means of special interest
    • A61B8/463—Displaying means of special interest characterised by displaying multiple images or images and diagnostic data on one display
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    • A61B8/46—Ultrasonic, sonic or infrasonic diagnostic devices with special arrangements for interfacing with the operator or the patient
    • A61B8/461—Displaying means of special interest
    • A61B8/466—Displaying means of special interest adapted to display 3D data
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    • A61B8/467—Ultrasonic, sonic or infrasonic diagnostic devices with special arrangements for interfacing with the operator or the patient characterised by special input means
    • A61B8/469—Ultrasonic, sonic or infrasonic diagnostic devices with special arrangements for interfacing with the operator or the patient characterised by special input means for selection of a region of interest
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B8/00—Diagnosis using ultrasonic, sonic or infrasonic waves
    • A61B8/48—Diagnostic techniques
    • A61B8/483—Diagnostic techniques involving the acquisition of a 3D volume of data
    • G—PHYSICS
    • G06—COMPUTING; CALCULATING OR COUNTING
    • G06T—IMAGE DATA PROCESSING OR GENERATION, IN GENERAL
    • G06T2207/00—Indexing scheme for image analysis or image enhancement
    • G06T2207/10—Image acquisition modality
    • G06T2207/10068—Endoscopic image
    • G—PHYSICS
    • G06—COMPUTING; CALCULATING OR COUNTING
    • G06T—IMAGE DATA PROCESSING OR GENERATION, IN GENERAL
    • G06T2207/00—Indexing scheme for image analysis or image enhancement
    • G06T2207/10—Image acquisition modality
    • G06T2207/10132—Ultrasound image
    • G06T2207/10136—3D ultrasound image
    • G—PHYSICS
    • G06—COMPUTING; CALCULATING OR COUNTING
    • G06T—IMAGE DATA PROCESSING OR GENERATION, IN GENERAL
    • G06T2207/00—Indexing scheme for image analysis or image enhancement
    • G06T2207/20—Special algorithmic details
    • G06T2207/20212—Image combination
    • G06T2207/20221—Image fusion; Image merging
    • G—PHYSICS
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    • G06T—IMAGE DATA PROCESSING OR GENERATION, IN GENERAL
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    • G06T2207/30—Subject of image; Context of image processing
    • G06T2207/30004—Biomedical image processing

Definitions

  • the invention relates to a method for displaying an object, in particular a biological tissue, according to claim 1 and an apparatus for displaying an object according to claim 14.
  • Ultrasound and endoscopy devices are known from medical technology, which allow surgical intervention under ultrasound control or visual inspection.
  • the US 601 97 24 A a corresponding ultrasonic device.
  • the problem underlying the invention is to provide a method that allows the best possible control of a taking place on an object engagement. Furthermore, a corresponding device is to be provided.
  • the first and the second device are designed in particular for intraoperative imaging.
  • the first and the second image that is generated with the first or the second device, for example, by imaging (projection) of at least a portion of the object in an image plane or by a 3D representation of the object.
  • the first image is an endoscopy image or a stereo endoscopy image
  • the first device is an endoscopy device, respectively. It is also possible, of course, that the first device is a non-endoscopic device.
  • the second picture is e.g. an ultrasound image, an MRI image, an X-ray image, a nuclear radiological image, an MRI image and / or a single photon emission tomography image and the second device corresponding to an ultrasound device, an MRI device, an X-ray device, a nuclear radiological Device, an MRI device and / or a single-photon emission tomography (SPECT) device.
  • SPECT single-photon emission tomography
  • the determination of the second coordinates of the pixels of the second image in the second coordinate system allows in particular a perspective correct (positionally correct) integration of at least a part of the second image in the first image.
  • the first device comprises an optical system (e.g., a camera), e.g. the second coordinate system is associated with an image plane of the optical system.
  • the optical system of the first device is, for example, a video camera (for example a CCD camera) with which a real-time image of the object to be examined can be generated.
  • a real-time image can also be generated by means of the second device, so that a combined real-time image of the object can be realized.
  • the object to be displayed is a biological tissue (e.g., a soft tissue), which method of the invention can be used to control operation of the tissue (e.g., removal of a tumor, such as a fibroid), i. H. intraoperatively.
  • a biological tissue e.g., a soft tissue
  • the method according to the invention is used in non-medical applications, for. B. to control a repair to a component.
  • a surgeon is provided with a depth representation of the relevant surgical area in addition to the endoscopy image.
  • the surgeon can assess a depth extent of a tumor that can not be recognized in the pure endoscopy image.
  • the additional depth information enables the surgeon, for example, to update his planning of the operation or the finding during the course of the operation.
  • the second coordinate system in which the coordinates of the pixels of the second image are mapped, is, for example, a two-dimensional coordinate system, e.g. an image plane of a camera of the first device is assigned.
  • the image plane of the camera is z. B., as already mentioned above, a CCD chip, wherein z.
  • the origin of the second coordinate system is located in a plane corresponding to a plane along which the CCD chip extends, d. H.
  • the coordinate axes of the second coordinate system extend in a plane whose position corresponds to the image plane of the camera of the first device.
  • the first device is a stereo endoscopy device that generates two perspectively different images by means of two optical systems (cameras).
  • an image of the first coordinates of the second image takes place both in the (second) coordinate system which is assigned to the image plane of the first camera and in the (further second) coordinate system which is assigned to the image plane of the second camera to be able to correctly integrate the second image in the correct position in both images of the stereoscopic endoscopy device.
  • the mapping of the first coordinates into the second coordinate system takes place in particular by means of a mapping (in particular by means of a transformation), which is determined by calibrating the first device (for example in the form of an endoscopy device).
  • This image is based in particular on a model of the first device (in particular of an optical system of the first device), parameters of the optical system being determined by the calibration.
  • a calibration pattern is imaged with the first device, wherein the spatial coordinates of the calibration pattern (eg relative to the first device) are determined by means of a position determination device and assigned to the coordinates of the image of the calibration pattern in the image plane of the first device.
  • a suitable calibration method in particular for a first device in the form of an endoscopy device, which can also be used to calibrate a distance determining device of an endoscopy device, is disclosed in the German patent application DE 10 2010 042 540.0 of 15.10.2010, to which reference is expressly made.
  • a distortion of the object is also detected by an optical system of the first device, ie distortion parameters of the mentioned model of the optical system of the first device are also determined, for example.
  • the mapping of the first coordinates of the pixels of the second takes place Image into the second coordinate system using these distortion parameters, ie a distortion function.
  • both the calibration of the first device and a calibration of the second device using a calibration wherein the calibration (eg integrally) are interconnected (ie form an assembly), wherein the spatial position of the calibration is determined in particular by a position determining device ,
  • determining the second coordinates of the pixels of the second image comprises determining the spatial position of the second device (eg an ultrasound head of an ultrasound device) by means of a position determination device and mapping the first coordinates of the pixels into spatial coordinates in one of Positioning device associated spatial coordinate system ("world coordinate system").
  • the position-determining device is, for example, a clinical navigation system or a component of a clinical navigation system that is configured using marking elements (which are arranged in particular on the second device, eg an ultrasound head) and a measuring device (in particular a measuring camera or a magnetic field sensor). allows determination of the spatial position (ie, the position and orientation) of an article such as the ultrasound probe.
  • the assignment of the image data of the second device to spatial coordinates takes place in particular after a corresponding calibration of the second device.
  • marking elements can be active (self-luminous) elements, such as LEDs, passive (non-luminescent) elements, such as reflective spheres, foils, special patterns (flat targets, laser engraving or natural patterns such as corners and edges) or magnetic field sources (eg in the form of current-carrying coils) can be used.
  • active (self-luminous) elements such as LEDs
  • passive (non-luminescent) elements such as reflective spheres, foils
  • special patterns flat targets, laser engraving or natural patterns such as corners and edges
  • magnetic field sources eg in the form of current-carrying coils
  • a measuring camera of a position-determining device is based in particular on the principle of a stereo camera, i. it has, for example, two sensor elements (in particular CCD chips) spaced apart from one another, which receive light from different angles at an object (in particular from a marking element of the position-determining device), so that the spatial position of the object can be reconstructed from the data of the sensor elements.
  • the spatial positions of the marker elements i. their spatial coordinates are determined in a given coordinate system assigned to the position-determining device. If the relative position of the marking elements in relation to the system to which they are attached is known, it is possible to deduce from the spatial positions of the marking elements on the position of the system. However, such position determination devices are known per se, so that it should not be discussed further here.
  • the z. B. also for determining the spatial position of the second device (eg the ultrasonic head of an ultrasound device), the spatial position of the first device (eg in the form of an endoscopy device and in particular their endoscope shaft) are determined, wherein the determination of the second coordinates of the pixels of the first Image is done using the particular spatial location of the first device.
  • the second device eg the ultrasonic head of an ultrasound device
  • the spatial position of the first device eg in the form of an endoscopy device and in particular their endoscope shaft
  • generating the combined image comprises determining coordinates of at least some of the pixels of the first image in the second coordinate system, wherein the pixels of the first image are replaced or overlaid with pixels of the second image with the corresponding second coordinates.
  • Overlaying (blending) the pictures can be done eg. B. be generated by adding the intensities of the pixels of the first image and the second image. It is also conceivable that a user can specify the degree of superposition (crossfade degree).
  • the first image and / or the second image may be edited prior to the combination, e.g. Using one or more filters (e.g., to introduce a hiding factor).
  • the second image may also be in the form of a 3D image (eg, a 3D ultrasound image, eg, a 3-D reconstruction) that may be generated by detecting (by moving, for example, the ultrasound head of an ultrasound device) a plurality of image planes.
  • a 3D image eg, a 3D ultrasound image, eg, a 3-D reconstruction
  • the spatial coordinates of the second image (second) coordinates associated with the image plane of the first device e.g, a 3D view of the object is thus integrated into the first image.
  • the device used to implement the method according to the invention is designed such that a user can switch between the 3D overlay and the overlay of the 2D image currently generated by the second device or completely switch off the integration of the second image.
  • a partial selection of pixels of the first image is determined by a selection process, and the particular pixels are replaced or superimposed by pixels of the second image with the corresponding second coordinates. For example, to select pixels to be replaced, a partial area is marked in the first image.
  • a partial area (partial section) of the object is selected (for example marked) and the combined image is created by replacing or superimposing pixels of the first image within the partial area of the object.
  • the combination of the first and the second image takes place exclusively in the marked subregion.
  • a partial section of the partial area of the object represented by the first image is selected as the partial area, or a partial area of the first image is determined which corresponds to the selected partial area (partial section) of the object.
  • the partial area of the object is selected by, as mentioned above, selecting a partial area of the first image, e.g. marked in the first picture will.
  • the marking (segmentation) of the subarea can, for.
  • they serve to characterize a tissue structure (for example a tumor) to be operated, so that the information of the second image relevant to the surgeon is mainly or exclusively displayed in this subarea in order to provide the desired depth information on the one hand, but the operator, on the other hand not to burden with unnecessary image data.
  • the marked subregion follows a movement of the object. This is made possible, in particular, by the fact that marking elements can also be arranged on the object (for example a patient to be operated) whose position is tracked by means of the mentioned position-determining device, so that the object position and thus in the generation of the combined image can be taken into account. Alternatively, this can also without marking elements on a recognition of the same Characteristics can be achieved in successive pictures and thus, for example, by tracking a deformation of the object ("non-rigid picture registration"); see below.
  • the partial area of the object is selected on the basis of a reconstruction of a three-dimensional area of the object, wherein the reconstruction is generated using a plurality of images generated by the second device.
  • the reconstruction of the three-dimensional region of the object comprises an interpolation between two temporally successive images of the second device as a function of their respective spatial positions determined by means of the position-determining device.
  • the interpolation of the two temporally successive images of the second device and / or storage of data generated by the interpolation can be done on a graphics card, the interpolation on the graphics card e.g. is calculated in parallel.
  • a plurality of light spots (fulcrums) are generated, whereby the light spots (light spots) can be generated simultaneously or sequentially. If the light spots are generated one after another, e.g. for each light spot, a first image showing the light spot is stored, the corresponding first images being evaluated during the marking process (in particular in real time) or after completion of the marking operation, and the sub-area composed of the successively generated light spots in the form of e.g. a 2D polygon surface or a volume is determined.
  • a first point in time output coordinates (in particular in the world coordinate system) of the subarea and at a second time updated coordinates of the subarea are determined as a function of the current position and / or shape of the object.
  • tracking of the position and / or the shape of the object takes place, for example, relative to the world coordinate system and thus to the coordinate system of the first device, for example by means of marking elements which are arranged relative to the object and rigid and non-rigid transformations thereon stand.
  • the marking takes place in that a light beam generated by the light source is continuously guided over the object and a recorded with the first device sequence of images is evaluated.
  • the position determination device is in particular a clinical navigation system, as already explained above.
  • the distance determining device with which in particular a distance between a section of the first device facing the object to be imaged and the object can be determined, comprises e.g. Means (in particular in the form of a laser) for projecting the light structure onto the object to be imaged and acting e.g. with an imaging optics and a camera of the first device together.
  • the means for projecting are arranged in particular in relation to an imaging optics of the first device, which serves for imaging the object in the image plane of a camera of the first device, that between the light beam emitted by the means for projecting and a light beam reflected on the object, that falls from the object into an imaging optics of the first device, an angle (eg 30 °) or a distance between the optical axis of the light beam and optical axis of the imaging optics, so that the position of the image of the light pattern generated on the object in the image plane the camera depends on the distance of the object to the first device.
  • an imaging optics of the first device which serves for imaging the object in the image plane of a camera of the first device, that between the light beam emitted by the means for projecting and a light beam reflected on the object, that falls from the object into an imaging optics of the first device, an angle (eg 30 °) or a distance between the optical axis of the light beam and optical axis of the imaging optics, so that the
  • a position vector between a portion of the first device and a portion of the light structure projected by the distance determining device that is, not only the distance but also the orientation of a connecting line between these portions is determined.
  • a suitable first device in the form of an endoscopy device having such a distance determining device is in the already mentioned German patent application DE 10 2010 042 540.0 which is also expressly incorporated herein by reference.
  • the region of interest of the object be marked using a light source.
  • the partial area is drawn in the first image (in digital form) (for example using a computer mouse or a drawing pen) or that the partial area is determined by means of a separate positioning device (for example a navigated instrument).
  • the partial area is displayed using a ray-casting method in the first and / or second image to convey a depth impression.
  • the ray-casting method is e.g. a maximum intensity projection, an average intensity projection, a freely definable transfer function and / or a surface projection used.
  • the distance determining device is connected to the first device (e.g., is a component of the first device), or that the distance determining device is a separate device (a separate instrument) from the first device, i. in particular spaced from the first device is arranged.
  • the selection of the subarea of interest is determined, for example, by applying a Boolean predicate function (eg, a threshold function) to pixels of the second image and / or an image analysis method (eg, a contour recognition method) to the second image.
  • a Boolean predicate function eg, a threshold function
  • an image analysis method eg, a contour recognition method
  • the partial area can be determined by specifying a threshold value and selecting a plurality of pixels of the second image (eg in the form of an ultrasound image) as a function of the threshold value.
  • the predetermined threshold value refers to the intensity of the pixels, for example, areas of the object are selected, to which only pixels of the second image are assigned, whose intensity exceeds the threshold (falls below).
  • This automatic selection could be used, for example, to select a tumor to be removed, whereby to select the tumor it would only have to be scanned ultrasonically in order to obtain a corresponding 3D reconstruction of the tumor.
  • a light source in particular a laser
  • the first device could serve to set a starting point for the 3D reconstruction.
  • the threshold-dependent selection may in particular be realized in the form of a filter which masks the background of the second image on the basis of the threshold value.
  • This type of selection (segmentation) of a partial area of the second image i.e., the object to be displayed
  • the threshold may also be customizable by a user.
  • the marked spatial subregion of the object is extrapolated to a closed subregion and a combined image is only generated if the region of the object detected with the second device intersects the closed subregion.
  • the marked portion is extrapolated to a closed cylinder.
  • the closed portion is detected using the above-described 3D reconstruction (e.g., a tumor).
  • the first image eg in the form of an endoscopic image
  • information regarding the spatial position of the second device is superimposed in order, for.
  • the second image for example an ultrasound image
  • the second image to be displayed on a separate display, and information relating to the position of the first device to be superimposed in this representation.
  • the spatial position of at least one tool can be determined by means of the position-determining device and the tool can be superimposed into the second image, taking into account its spatial position and the spatial position of the second device.
  • the second image with the displayed tool according to step e) is combined with the first image.
  • a time delay of the image triggering of the first device, the second device and the position determination of the position determination unit is determined and is available for the timing by a central processing unit for displaying the combined image.
  • the first and the second coordinate determination device are designed in particular in the form of software or a correspondingly programmed electronic device (computer, microchip, etc.).
  • the imaging device may be in the form of software or suitably programmed hardware (e.g., a graphics card).
  • the device also comprises marking elements which are arranged on the first device (for example an endoscopy device) and / or the second device (for example an ultrasound head of an ultrasound device), wherein by means of a position-determining device, a spatial position of the marking elements and thus of the first device and / or the second device can be determined.
  • the position determining device is, in particular, a clinical navigation system that includes a position determining device, such as a measuring camera.
  • the device 1 comprises a first device in the form of an endoscopy device 2 (eg in the form of a hystoroscopy device) and a second device in the form of an ultrasound device 3. Both the endoscopy device 2 and the ultrasound device 3 serve to generate an image of an object in the form of a tissue 4th
  • the endoscopy device 2 is a rigid endoscope which has a rigid endoscope shaft 21 in which an endoscope optical system for imaging an object is located in an image plane of a camera 22 of the endoscopy device 2.
  • a possible embodiment of the endoscopy device 2 is in the already mentioned German patent application DE 10 2010 042 540.0 described.
  • the camera 22 and the ultrasound device 3 are connected to a data processing system in the form of a computer 100 for processing (eg digitizing and filtering) and displaying the respectively generated image data.
  • Marking elements in the form of marking spheres 51-53 are arranged on the endoscopy device 2.
  • marking balls 54 - 56 are arranged, wherein the marking balls 51-56 a determination of the position, d. H. allow both the location where the respective device is located, as well as the orientation of the respective device.
  • the device 1 according to the invention has a position-determining device in the form of a clinical navigation system 6, which comprises a measuring camera in the form of a stereo camera 61.
  • the position of the marking spheres 51 - 53 attached to the endoscopy device 2 and the marking spheres 54 - 56 arranged on the ultrasound head 31 of the ultrasound device 3 and thus of the endoscopy device 2 and the ultrasound device 3 can be determined.
  • the position of the image plane of the endoscopy camera 22 as well as the position of the area (e.g., a plane) of the tissue 4 detected by the ultrasound probe 31 are also known, e.g. updated in real time during a (manual) movement of the endoscopy device 2 and / or the ultrasound head 31.
  • the ultrasound image generated with the ultrasound device 3 is therefore possible to combine the ultrasound image generated with the ultrasound device 3 in perspective correctly with the endoscopy image generated by the endoscopy device 2.
  • (first) coordinates of pixels of the ultrasound image are assigned spatial coordinates in a spatial coordinate system assigned to the position-determining device 6 (the measuring chamber 61), the spatial coordinates to be assigned to the ultrasound pixels being points of the region of the tissue 4 detected with the ultrasound device 3.
  • These spatial coordinates associated with the pixels of the ultrasound image are transformed into the (virtual) image plane of the camera 22, ie into a plane corresponding to their position of the image plane, using a (simulated) image determined by calibrating the endoscopy device 2
  • Camera 22 corresponds, shown and determines (second) coordinates of the ultrasound pixels with respect to the image plane of the camera 22.
  • FIG. 3 An example of such a perspective correctly combined image shows the FIG. 3 , where the FIG. 3 an endoscopy image taken with the endoscopy device 2 is based, which in FIG. 2 is shown.
  • FIG. 3 is a portion of the endoscopic image 7 by an ultrasound image 8 er-10 sets, wherein the coordinates of the points of the original ultrasound image were transformed according to the method described above.
  • the positionally correct integration of the ultrasound image into the endoscopy image which is made possible in this way, provides depth information of the tissue in addition to the optical information of the endoscopy image.
  • the depth of the ultrasound image ie position of the plane, which is detected by the ultrasound head and displayed in the ultrasound image 8, z. B. by a manual movement of the ultrasonic head 31 of the ultrasonic device 3 are changed. It is also conceivable that, instead of the 2D ultrasound image shown, an SD reconstruction of the tissue is integrated.
  • a partial region of the tissue 4 is selected and the endoscopic image 7 is replaced or superimposed only in a section through the ultrasound image 8 which corresponds to the selected subregion of the tissue 4.
  • the selection of a subregion of interest may, for example, be carried out with the aid of a distance determining device of the endoscopy device, it being possible for a laser of the distance determining device to generate light spots on the tissue 4 which mark the subregion.
  • the position of the light spot is marked with a cross.
  • the marking is carried out with the aid of the laser in that the laser scans and registers several points of the tissue, as already explained above.
  • additional information can be displayed, eg. B.
  • Information regarding the orientation of the ultrasonic head 31 can be z. B. by .Enblenden a structure 9, which marks the position of the detected by the ultrasonic head 31 Thomaskegels 9, take place.
  • The. Structure 9 is an "augmented reality" overlay. Conceivable are other such displays, for example, indicate a direction along which the ultrasound head must be moved to detect a marked portion of the tissue.
  • FIGS. 4 and 5 each show a combined image with a preoperative CT image 8 'displayed in a first image 7 (eg taken by an endoscope or another camera).
  • a navigated instrument 150 is shown, ie an instrument whose spatial position was determined by the navigation system (see above), the instrument 150 having, in particular, corresponding navigation marking elements.
  • the position of the instrument (tool) 150 is indicated in the combined image in the correct position with respect to the CT image 8 'by a linear marking 101.
  • an extension of the axis of the instrument 150 is marked (cross).

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Claims (15)

  1. Méthode de sélection de points d'image dans la représentation d'un objet dans l'imagerie intra-opératoire, en particulier un tissue biologique, comprenant les étapes:
    a) Générer une première image (7) d'au moins une région partielle de l'objet (4) à l'aide d'un appareil d'endoscopie comme premier appareil (2);
    b) Générer une seconde image (8, 8') au moins de la région partielle de l'objet (4) de l'étape a) à l'aide d'un second appareil (3);
    c) Déterminer des premières coordonnées d'au moins certains points d'image de la seconde image dans un premier système de coordonnées;
    d) Déterminer des secondes coordonnées des points d'image de la seconde image en mappant les premières coordonnées dans un second système de coordonnées qui est différent du premier système de coordonnées et qui est attribué au premier appareil (2); et
    e) Générer une image combinée de l'objet (4) à partir de la première image et pour des points d'image sélectionnés à partir de la seconde image en utilisant les secondes coordonnées des points d'image de la seconde image qui ont été déterminées, caractérisé en ce que
    f) la sélection des points d'image à combiner est déterminée par la sélection d'une région partielle de l'objet (4), dans lequel
    • le premier appareil (2) comprend une source de lumière et la région partielle de l'objet (4) à sélectionner est marquée en générant au moins un point lumineux sur l'objet (4) à l'aide de la source de lumière, ou
    • la région partielle de l'objet (4) est marquée à l'aide d'un instrument navigué séparé,
    g) de sorte que la génération de l'image combinée dans l'imagerie intra-opératoire se produit en remplaçant ou superposant des points d'image de la première image (7) dans la région partielle de l'objet (4) par les points d'image sélectionnés de la seconde image.
  2. Méthode selon la revendication 1, dans laquelle le marquage d'une région partielle de l'objet (4) à l'aide de points lumineux est caractérisé par
    - marquer une région partielle spatiale de l'objet (4) à l'aide d'une pluralité de points lumineux;
    - déterminer la position spatiale du premier appareil (2) en utilisant un appareil de détermination de position (6);
    - déterminer la distance entre le premier appareil (2) et les points lumineux générés avec l'aide d'un appareil de détermination de distance;
    - dans laquelle la sélection de la région partielle se produit en déterminant la position spatiale de la région partielle en déterminant les coordonnées spatiales des points lumineux dans le système de coordonnées de l'appareil de détermination de position (6) en utilisant la position spatiale déterminé du premier appareil (2) et de la distance déterminée.
  3. Méthode selon une des revendications 1 ou 2, caractérisée en ce que la région partielle spatiale marquée est extrapolée à une région partielle fermée, et une image combinée est générée seulement si la région de l'objet (4) détectée par le seconde appareil (3) coupe la région partielle fermée.
  4. Méthode selon l'une quelconque des revendications précédentes, caractérisée en ce que la région partielle extrapolée fermée, les coordonnée spatiales des points lumineux, les régions partielles de la revendication 1 et/ou au moins certaines des distances déterminées sont affichées dans la première et/ou la seconde image.
  5. Méthode selon l'une quelconque des revendications 2 à 4, caractérisée en ce que l'appareil de détermination de distance est relié au premier appareil (2).
  6. Méthode selon l'une des revendications précédentes, caractérisée en ce que la sélection des points d'images à combiner peut en outre être limitée en appliquant une fonction de prédicat booléen à des points d'image du seconde image et/ou un procédé d'analyse d'image à la seconde image.
  7. Méthode selon la revendication 1, caractérisée en ce que la région partielle de l'objet (4) est sélectionnée en utilisant une reconstruction d'une région tridimensionelle de l'objet (4), dans laquelle la reconstruction est générée en utilisant une pluralité d'images générées avec le second appareil (3).
  8. Méthode selon la revendication 7, caractérisée en ce que la reconstruction de la région tridimensionelle de l'objet (4) comprend une interpolation entre deux ou plusieurs images du second appareil (3) en succession chronologique en fonction de leurs positions spatiales respectives déterminées à l'aide de l'appareil de détermination de position (6).
  9. Méthode selon l'une quelconque des revendications précédentes, caractérisée en ce que la région partielle de l'objet (4) est représenté en utilisant une méthode raycasting dans la première et/ou la seconde image (7), afin de procurer une impression de profondeur.
  10. Méthode selon la revendication 9, caractérisée en ce que la méthode raycasting utilise une projection d'intensité maximale, une projection d'intensité moyenne, une fonction de transfert librement définissable et/ou une projection de surface.
  11. Méthode selon l'une quelconque des revendications précédentes, caractérisé en ce que, dans un premier instant, des coordonnées initiales de la région partielle et dans un seconde instant des coordonnées actualisées de la région partielle sont déterminées en fonction de la position actuelle et/ou de la forme de l'objet (4).
  12. Méthode selon l'une quelconque des revendications précédentes, caractérisé en ce que la première image (7) est une image générée avec une optique projective sur un plan 2D, en particulier une image endoscopique ou une image stéréoendoscopique.
  13. Méthode selon l'une quelconque des revendications précédentes, caractérisée en ce que la seconde image est une image intra-opératoire, en particulier une image ultrasonore, ou une image préopératoire, en particulier une image IRM, une image radiographique, une image nucléaire-radiologique, une image de tomographie par émission de photons unique et/ou une fusion de ces images et le second appareil (3) est adéquatement un appareil à ultrasons, un appareil IRM, un appareil à rayon X, un appareil radiologique nucléaire, un appareil de tomographie par émission de photons unique et/ou un appareil de fusion d'image.
  14. Appareil pour la représentation d'un objet pour effectuer une méthode en imagerie intra-opératoire selon l'une quelconque des revendications précédentes avec
    - un appareil d'endoscopie comme premier appareil (2) pour générer une première image (7) d'au moins une région partielle d'un objet (4);
    - un seconde appareil (3) pour générer au moins la région partielle d'une seconde image de l'objet (4) de l'étape a);
    - un premier appareil de détermination de coordonnées pour déterminer des premières coordonnées d'au moins certaines points d'images de la seconde image dans un premier système de coordonnées;
    - un seconde appareil de détermination de coordonnées pour déterminer des secondes coordonnées des points d'image de la seconde image en mappant les premières coordonnées dans un seconde système de coordonnées qui est différent du premier système de coordonnées et qui est attribué au seconde appareil (3); et
    - un appareil de génération d'image pour générer une image combinée de l'objet dans l'imagerie intra-opératoire à partir de la première et la seconde image en utilisant les secondes coordonnées des points d'images de la seconde image qui ont été déterminées, dans laquelle le premier appareil (2) comprend une source de lumière pour générer au moins un point lumineux sur l'objet (4) ou un instrument navigué séparé pour sélectionner la région partielle de l'objet (4).
  15. Appareil selon la revendication 14, caractérisé par des éléments de marquage (51-56) agencés sur le premier et/ou le seconde appareil (2, 3), aussi bien qu'un appareil de détermination de position (6) pour déterminer la position spatiale des éléments de marquage (51-56) et ainsi la position spatiale du premier et/ou du seconde appareil (2, 3).
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EP3330922A1 (fr) 2018-06-06
DE102011078212B4 (de) 2017-06-29
EP3076369A1 (fr) 2016-10-05
US20180053335A1 (en) 2018-02-22
EP3330922B1 (fr) 2019-05-15
US20140218366A1 (en) 2014-08-07
DE102011078212A1 (de) 2013-01-03
US9792721B2 (en) 2017-10-17
EP2727082A2 (fr) 2014-05-07
WO2013001031A2 (fr) 2013-01-03
US10706610B2 (en) 2020-07-07
WO2013001031A3 (fr) 2013-03-21

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